Tomorrow We Die (First Responders Book #2)

By Shawn Grady

Jonathan Trestle is a paramedic who's spent the week a few steps behind the angel of death. When he responds to a call about a man sprawled on a downtown sidewalk, Trestle isn't about to lose another victim. CPR revives the man long enough for him to hand Trestle a crumpled piece of paper and say, "Give this to Martin," before being taken to the hospital.

The note is a series of dashes and haphazard scribbles. Trestle tries to follow up with the patient later, but at the ICU he learns the man awoke, pulled out his IVs, and vanished, leaving only a single key behind. Jonathan tracks the key to a nearby motel where he finds the man again--this time not just dead but murdered. Unwilling to just let it drop, Jonathan is plunged into a mystery that soon threatens not only his dreams for the future but maybe even his life.

• Language: English
• Publisher: Baker Publishing Group
• Release date: Jul 1, 2010
• ISBN: 9781441212122

Shawn Grady

Shawn Grady has served for more than a decade as a firefighter and paramedic in Reno, NV, where he lives with his wife and three children. Named the "Most Promising Writer" at the 2008 Mt. Hermon Writers Conference, he is the author of Through the Fire. Visit his website at shawngradybooks.com.

Book preview

TOMORROW

WE

DIE

SHAWN GRADY

© 2010 by Shawn Peter Grady

Published by Bethany House Publishers

a division of Baker Publishing Group

P.O. Box 6287, Grand Rapids, MI 49516-6287.

E-book edition created 2010

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means—electronic, mechanical, photocopying, recording, or otherwise—without the prior written permission of the publisher. The only exception is brief quotations in printed reviews.

ISBN 978-1-4412-1212-1

Library of Congress Cataloging-In-Publication Data is on file at the Library of Congress, Washington, DC.

This book is a work of fiction. Names, characters, businesses, organizations, places, events, and incidents either are the product of the author’s imagination or are used fictitiously. Any resemblance to actual persons – living or dead – events, or locales is entirely coincidental.

Scripture quotations are from the New King James Version of the Bible. Copyright © 1979, 1980, 1982 by Thomas Nelson, Inc. Used by permission. All rights reserved.

For

Sarah Beth

"If the dead do not rise, ‘Let us eat and drink,

for tomorrow we die.’ "

– SAUL OF TARSUS

Contents

CHAPTER 01

CHAPTER 02

CHAPTER 03

CHAPTER 04

CHAPTER 05

CHAPTER 06

CHAPTER 07

CHAPTER 08

CHAPTER 09

CHAPTER 10

CHAPTER 11

CHAPTER 12

CHAPTER 13

CHAPTER 14

CHAPTER 15

CHAPTER 16

CHAPTER 17

CHAPTER 18

CHAPTER 19

CHAPTER 20

CHAPTER 21

CHAPTER 22

CHAPTER 23

CHAPTER 24

CHAPTER 25

CHAPTER 26

CHAPTER 27

CHAPTER 28

CHAPTER 29

CHAPTER 30

CHAPTER 31

CHAPTER 32

CHAPTER 33

CHAPTER 34

CHAPTER 35

CHAPTER 36

CHAPTER 37

CHAPTER 38

CHAPTER 39

CHAPTER 40

CHAPTER 41

CHAPTER 42

CHAPTER 43

CHAPTER 44

CHAPTER 45

CHAPTER 46

CHAPTER 47

CHAPTER 48

CHAPTER 49

ACKNOWLEDGMENTS

ABOUT THE AUTHOR

CHAPTER 01

I spent the day chasing the Angel of Death.

Being a paramedic can be a hard life, living in an ambulance for twelve hours a day, parked on street corners, inhaling reheated 7-Eleven burritos and Red Bull. There are shifts that wear on you, when no matter what you do, even if you run calls as smoothly as possible and do everything just right, that despite all the king’s horses and all the king’s men . . .

Death walks in without remorse.

I’ve seen people’s spirits leave them before my eyes. And there is always something different in the room right then, something transcendental, as if unseen ushers are escorting a soul from this world. The entire week had been like that for my partner and me – always one step behind the Reaper.

So you can imagine my surprise when we actually caught him.

The harder my partner pushed on the gas pedal, the longer 395 northbound grew.

I pounded on the dashboard. Come on, you pig.

That’s all she’s got. Governor’s kicked in. Bones hunched over the steering wheel, bouncing his head to an inaudible rhythm.

I felt our momentum level out at seventy-five miles per hour. The management made sure to keep our speed under control, among other things.

I sat back in my seat, placing my right foot up against the dash and the door. Is this our third cardiac arrest?

He nodded. Just sifting with his scythe. Folks better break off a hyssop branch, if you know what I’m saying.

I had no idea what he was saying.

But that wasn’t unusual.

My partner, Thaddeus McCoy, had been called Bones for as long as I’d known him. The nickname seemed especially fitting, even beyond his surname, given that he wore black medic pants – not the dark navy blue like everyone else – and a black leather belt that wrapped around his front with no visible buckle on it. His pants tapered down near the top of his boots, giving his uniform a 1960s Star Trek appearance. He sported a wiry body frame with pale Germanic skin, closely cropped straw-colored hair, and a well-groomed moustache that, were it shaved any smaller above his lip, would bestow upon him a Charlie Chaplin–like countenance.

Our call had come in as an unknown man down on the sidewalk at First and West, in front of the church – unknown if conscious or breathing. Which, at the risk of sounding jaded, was generally code for drunk guy on the street corner. But one thing I’d learned as a medic was to never judge too early. And based on the updated report we’d received from dispatch, this sounded like the real thing. A couple minutes into our response the dispatcher advised us that per an off-duty park ranger on scene, our patient was pulseless and apneic, and bystander CPR had been initiated. She also mentioned that the Reno Fire Department had a working structure fire just north of downtown and their next-in unit would likely arrive several minutes after us. If this guy had a chance, we were it.

Look, Jonathan, Bones squealed in a high Mr. Bill voice, holding the radio microphone up by his side window, light posts and cars whizzing past, I’m the fastest mic in the world.

I refused to respond to his impromptu puppet, knowing that if I so much as acknowledged it, I would find myself talking to a derisive plastic microphone for the rest of the shift. I turned my focus to the map book in my lap. So you want to take Mill downtown and then jog over to First and West.

This time Bones spoke in the guttural voice he uses for our ambulance, Medic Two, which through the outpouring of his hyperactive imagination has also grown a sentient, albeit simpleton, personality. Yes, Jonathan. That sounds good. . . . And I love you.

That’s great. I cringed with the realization that I’d just validated his anthropomorphic creation.

Jonathan, in Medic Two’s deep, gravelly voice he continued, I love you.

I patted the vinyl on the dashboard as if it were a horse’s neck. Thanks, Medic Two.

Jonathan?

Yes?

Do you love me too?

There was no escaping this now.

Yes, yes I do, Medic Two.

More than Medic Seven?

Yes, more than Medic Seven.

Good. I love you too. . . . Jonathan?

I looked up at the ceiling of the cab. Yes?

I’m not a pig. I’m really fast.

You’re right, Medic Two. My bad.

Bones greeted other vehicles in Medic Two’s voice as we wailed passed them on the freeway. Hello. Hi. I love you.

At the Mill Street exit, we hit heavy traffic. Most cars pulled to the right, but one older model GMC pickup skidded to a stop in front of us. Bones locked up our brakes and laid on the air horn. I lurched forward in my seat, held tight by the shoulder belt.

Pull to the right! Bones motioned with his hands, mouthing his words with exaggeration. Pull. To. The. Right.

Getting impatient, I picked up the PA mic. Pull to the right. Yes, you. Pull to the right.

The driver turned his wheel and rolled right, giving us just enough room to squeeze by on the shoulder to the left. Bones shot a friendly glance his direction as we passed. Already five minutes into our response, the chances of our patient surviving decreased exponentially with every second lost. With permanent brain death occurring after six minutes in cardiac arrest, time was running out.

We shot past County Hospital and screamed west into the heart of downtown Reno. We wove between and around taxicabs and shuttle busses and passed weekly motels. The snow-covered Sierras disappeared behind the towering casinos. We swung over to First Street, and Bones killed the siren save for a couple whoop-whoops as he brought the box to a stop in front of the church. There on the sidewalk, in the shadow of a hundred-year-old vine-covered Methodist sanctuary, knelt a balding park ranger doing chest compressions on a pale man in a long black overcoat.

Medic Two’s on scene – no fire department, I reported to dispatch and opened the door. The spring air felt brisk. I grabbed the defibrillator off the gurney in back and brought it to the patient’s side, kneeling by the park ranger. Go ahead and stop compressions.

The patient looked to be in his sixties, sporting a scraggly gray beard and wispy hair. Yellowish vomit oozed down the side of his face. His eyes were in a fixed and dilated stare. Bones cut off his shirt. I placed the defibrillator patches on his chest and looked at the monitor to examine his heart rhythm.

Coarse V-fib, Bones. Charging to one-twenty. I’m clear – everyone clear. The park ranger held his hands up and glanced at his knees.

I delivered the first biphasic electrical shock and watched the man’s body arch in tension and then relax again flat upon the concrete.

Still fib. Charging to one-fifty. Everyone clear.

I delivered a second shock. No change.

Charging to two hundred. Clear.

The Shock button glowed a fiery red, the air taut with the high-pitched whining of potential energy.

God, just let me have this one back.

My finger met the button. The man’s body surged upward.

What followed was silence – and the long flat line of asystole.

I exhaled and nodded to the park ranger. All right. Let’s resume compressions. Bones, you want me to bag him while you set up to intubate?

Yes, sir, I do.

I inserted a curved piece of plastic to hold back the man’s tongue from his throat. And after placing a mask over his mouth and nose, I squeezed the purple bag attached to it to inflate his lungs and breathe for him. As soon as we get that tube, let’s drop some epi down –

The monitor beeped.

I waved off the park ranger. Hold up.

The angled complexes of an organized heart rhythm graced the screen’s black background – like a repetitive drawing of a small foothill leading to a mountain peak that dropped into a valley on the opposite side. Slow at first, then more rapid.

Sinus tach. We got pulses with that?

Bones reached for a carotid pulse at the neck. I got one here.

I felt the patient’s wrist. Yeah, me too. I’ve got radials.

We’d gotten him back. Hope sprang forth in me. Only time would tell if we’d saved his heart but not his brain.

He was still unconscious, so Bones zipped open the intubation kit and prepared to place a breathing tube down the patient’s throat.

I wrapped a tourniquet tight around his arm. The only vein I could feel popped up in the crook of his elbow. I swabbed it with alcohol and inserted the needle. A burgundy flash of blood filled the needle hub. I advanced it just a tad more before threading the plastic catheter into the vein.

Sharp out. I placed the bare needle flat on the sidewalk and hooked up IV tubing connected to a bag of saline.

Blanket protocol for a patient on the streets like this involved a medication called Narcan to reverse the effects of possible heroin overdose. I administered the standard dose and squeezed the IV bag to flush it into his bloodstream.

Bones clicked into place a curved steel blade on a cylindrical handle. He twirled the sickle-shaped laryngoscope in his left hand and pulled out the short piece of plastic that held back the patient’s tongue. He positioned the head and shined the light from the end of the laryngoscope blade down the man’s throat. With his opposite hand, he angled an endotracheal tube in toward the vocal cords.

The park ranger stood wide-eyed, staring at the twisted progression of it all.

I picked up the needle from the pavement and plunged a drop of blood onto a glucometer to check our patient’s blood-sugar level. The display flashed a normal reading.

Bones withdrew the laryngoscope blade and picked up the bag mask. He seated it over the man’s mouth and squeezed. I’m having a hard time seeing down there. I’ll give it another go.

He set the bag mask down and positioned himself for a second attempt. He squinted down the man’s gullet, his fist straining to keep the handle in position.

Our patient bolted upright.

Bones flipped on his back, the laryngoscope skidding away like a hockey stick on ice.

The man flashed wild eyes, found me, and grabbed my shirt collar. He labored to breathe, staring with constricted pupils and sweat beading on his brow. His mouth trembled, trying to form a sentence.

He found words with a winded, raspy voice. Arepo . . . Arepo the Sower.

Hey, it’s okay. We’re the paramedics. Here, let’s lay you –

Listen. He grabbed the back of my neck, struggling to keep himself upright. His hands felt dirty and rough. Arepo the Sower . . . holds the wheels at work.

I shook my head and lifted his arm away. He’s delirious. Here, you need oxygen.

He slipped back toward the concrete.

Here, yeah, lie back. Bones, let’s throw him on some O’s.

Bones reached for an oxygen mask. The man tensed and winced, his heart rhythm oscillating on the heart monitor.

Bones shifted the screen to see it. He’s throwing runs of V-tach.

The man reached inside his coat and, with a trembling hand, produced a folded piece of notebook paper. He grasped my forearm and forced it into my palm.

Martin. His eyes locked with mine. Give this to Martin.

CHAPTER 02

The defib alarmed.

Color drained from his face.

I squeezed his shoulders. Wait. What? Who’s Martin?

Bones picked up the laryngoscope. He’s bradying down.

The man slumped to the sidewalk. On instinct I rolled him away from me. It wasn’t five seconds later that he spewed yellow chunks all over the park ranger’s shoes.

Bones cleared the man’s mouth with the portable suction catheter.

A vigorous sternal rub didn’t wake him.

Bones reset his intubation equipment and talked to himself. GCS less than eight. Intubate.

A fire engine siren blared a couple blocks out.

Things moved too fast to process.

Slow down . . . stick with ABCs.

Airway.

His respirations were shallow and slow. His skin felt cool and sweaty. I held his wrist but couldn’t find a radial pulse anymore, only a thready carotid on the neck at thirty beats per minute. Bones placed his stethoscope in his ears one-handed, the other hand holding an inserted tube at the man’s lips. He listened to lung sounds to make sure his tube was good.

Airway secured. Progress. The rumble of a fire engine exhaust brake sounded behind me, followed by the squeak and hiss of an air brake.

We needed to get our patient’s heart rate up before it stopped beating again. Bones, I’m gonna try to pace him.

I set the defib to deliver sequential minishocks of electricity to our patient’s heart. The pectoral muscles in his chest twitched. Heartbeats flicked faster on the display. Okay, we’ve got electrical capture.

Bones nodded. And I’ve got radials with that.

A firefighter walked up. Where you guys at?

Let’s grab a quick blood pressure and then load and go.

The fire captain clipped a radio mic to his shirt. Saint Mary’s?

Yeah, that’ll be closest. Mind if we take two of your guys?

Not at all.

One firefighter moved to the man’s head to squeeze the bag now attached to the breathing tube. The other pumped the handle of a blood-pressure cuff with a stethoscope in his ears.

He bled off the air. Eighty-two over fifty.

Okay. I blew out a quick breath. Let’s roll him on the flat and get him loaded onto the gurney.

We buckled the patient on the bed. My eyes met the park ranger’s. Thank you.

He gave a nod.

I climbed into the back of the ambulance.

Bones looked back through the doghouse, the small opening between the cab and the patient area. All set?

Let’s roll.

He flicked on the siren and set off for the ER. I found myself wishing I had gathered more history on scene. Had our patient been complaining of anything before he passed out? Did he simply go into spontaneous cardiac arrest? Had the Narcan helped at all?

I turned my focus to a vial of amiodarone and inserted a needled syringe to draw it up. The medication would deter his heart from going back into a lethal rhythm. I flicked the bubbles to the top of the syringe and injected the contents into a second IV bag I’d hung from the gurney pole.

The siren shut off and the ambulance jostled into the parking lot. It turned, the back-up alarm sounded, and through the back windows the emergency room doors drew closer. The firefighter across from me reported another blood pressure similar to the first.

Questions about the patient abounded in my mind.

What happened to you?

What were you trying to tell me?

I took a last listen to lung sounds to ensure the breathing tube was still in place, then stood up and organized the myriad wires and IV tubing aboard the gurney.

All right. Monitor, O² bottle, tube’s secure, IV bags and tubing . . . we’re all set.

The ambulance shut off. Bones came around back and swung open the doors. He raised his arms, grinning with televangelist grandeur. Thou, unknown man down. Come forth.

We got off work an hour late after cleaning and restocking the ambulance and finishing paperwork. The Sierras stood dark and majestic, silhouetted by the day’s crimson farewell. What was it they said in the navy? Red at night, sailors delight. Red in the morn’, sailors mourn.

Norah Jones escorted me home, her sultry, smoky voice enticing Come Away With Me through the car speakers. The black leather of my VW Passat presented a comfortable contrast to the gritty chaos of the workday. I longed to shed my uniform, to be free of the sublime stench of the ambulance.

A paper crinkled in the side pocket of my pants. And I heard my patient’s raspy voice. . . . Arepo the Sower holds the wheels at work.

I pulled out the note and unfolded it atop the steering wheel. A series of markings littered both sides of the sheet – straight and curved lines, dashes and slashes.

Chicken scratches.

I tossed it onto the passenger-side floor.

Streetlights glowed along the sidewalks. The lengthening day disappeared in the west. Blue and red lights illumined my dash.

That look in his eyes . . .

Give this to Martin.

I shrugged it off, watching the road zip beneath me. Norah finished. The Byrds came on. "To everything . . . turn, turn, turn."

I laughed and shook my head. The man had been obviously low on oxygen and perhaps delusional. A paper full of scribbles meant nothing. I was going home. I was going to relax and get away from work and have my own life for at least the next ten hours.

The notepaper sat on the floor.

I couldn’t see throwing it away in good conscience. That left me one option . . .

I hit the blinker at the next intersection. I’d turn around, take a half hour to go back to Saint Mary’s, and give the piece of paper to the man – or at least to his nurse – and be done with it. The sooner I found him, the sooner I could drop it off and be home in a hot shower.

Night had fallen by the time I pulled into the hospital parking lot. The fatigue in my muscles made it feel later than it was. The evening air bit sharp with the reminder that winter had yet to fully loosen its grip.

At the ER doors I punched in the key code to enter. By now they probably would have moved our patient to the cardiac intensive care unit, but I decided to stop and ask to be sure. A multitasking middle-aged nurse with long, frizzy brown hair gave me three seconds, time enough for her to say, CIC, ’bout an hour ago, before trading the clipboard chart she was holding with a new

Reviews for Tomorrow We Die (First Responders Book #2)

[cclpad · Rating: 5 out of 5 stars]

I loved this book. Fast paced, adrenaline rush, page turner. All adjectives that fit.

[hischild_1 · Rating: 5 out of 5 stars]

Tomorrow We Die, the second book by author Shawn Grady, is the story of the young paramedic, Jonathan Trestle. Jonathan is merely biding his time as a paramedic while he waits to begin medical school on a full scholarship. It seems that his well-laid plan is in serious trouble when patients begin mysteriously dying for inexplicable reasons. Thus begins the story of Jonathan's quest for truth. He is not content to accept the loss of his patients and sets off to discover the reason for the untimely deaths. In the process, he gets much more than he bargained for and that is what makes this tale so appealing. Add in a scandal, a long-standing grudge, and a bit of romance and you have a story that will keep your eyes riveted on the pages until the final word. Tomorrow We Die is another winner for author, Shawn Grady. It may be a work of fiction but the realistic action and the attention to detail make the reader feel as if they have been vaulted into reality. If you are a reader like me who enjoys books about the medical profession, you will love Shawn Grady. His personal knowledge of the profession combines with his gift for story-telling to make him an author who can't write fast enough to please his fans.

[reviewsbymolly · Rating: 5 out of 5 stars]

I have to confess that, on top of Historical and Amish novels, I am a complete and utter SUCKER for medical suspense and dramas! I used to love to watch E.R., House,and, back in the day, Doogie Howser, MD! I also loved the fast paced thrills of watching the real life medical shows. My blood and heart rate was always pumping into overdrive! Reading Shawn Grady's work for the first time falls into that blood-rush thrilling sensation! LOVED it! From the minute I opened to the first page, Grady thrust me straight into Jonathan's fast paced environment. I felt myself transform into a paramedic and instead of feeling the pages in my hand, I felt like I was right there beside Jonathan working on patients, all with God by our side. It was such a rush of overloaded adrenaline and mystery! Jonathan had a fast paced life of a paramedic AND a med student but he also had the thrills of being drawn into an unusual mystery, that could cost him his life! I literally turned page after page with a racing heart because I HAD to see what happened next, HAD to feel that next rush of adrenaline! If you love suspense and medical thrillers, then this book is DEFINITELY for you! Five stars all the way with high recommendations! It's perfectly created with God's guidance and protection, suspense and mystery, and humor to keep the reader hooked til the end! I can't wait for more of Shawn Grady's work! I am making it a MUST to go back and read his first book, Through the Fire!